It Mental Health

Howard (****) offers a pretty clear and concise mentally ill character in his movie A

Beautiful Mind [motion picture]. Working in psychiatry it is not at all uncommon to meet someone like “John Nash.” Though schizophrenia is degenerative and chronic in nature, this learner has always said it was the intelligent patients that scared her the most. Not necessarily because they were threatening in any way but because their minds appear to be so complex, many times with numerous ideas forming at once. In her experience, this group of mentally ill patients can be quite convincing to the point it may easily become difficult to decipher a tale from reality. In addition, she has acknowledged nearly all of those diagnosed with schizophrenia usually live alone, prefer isolation, and rarely do they bring anyone else into their appointments. As displayed with the movie’s main character, schizophrenia normally worsens over time making it disabling in certain or all aspects of their life. Thus, to answer the question above, yes, “John Nash” demonstrated a very accurate account of paranoid schizophrenia, not otherwise specified. Aspects of having delusions, auditory/visual hallucinations, social awkwardness, obsessive nature, extreme intelligence, an inability to function adequately in child rearing, excessive smoking, marital disconnection, and eventually losing friends/relatives from a deteriorating independence are hallmark signs of the disorder.

1. What type of schizophrenia is depicted, can it be specified?

As stated in response to the above question, the learner believes John’s character displays symptoms consistent with recurrent paranoid schizophrenia. Because his delusions and hallucinations became so prominent and chronic in nature but is not due to substance abuse, trauma, or a medical condition, the diagnosis cannot be specified.

2. How does the disorder affect not just him but his system? Family, wife, kids, socially, work

John’s mental illness was extremely acute which potentially put himself and his family in harm’s way. He obviously could not be alone with his child nor was he capable of caring for him on any substantial level. Marital discord was imminent as he eventually is portrayed as nearly a stranger in comparison to his former disposition. The couple no longer enjoyed their harmonious interactions and lacked a close knit connection which they once enjoyed. Sexual intimacy was soon replaced by the wife taking a caregiving role for her husband while she dealt with her own disappointment and feelings of anger about the situation she married into. Additionally, the future of the son’s mental health would be of concern in the future due to a possible genetic link.

Occupationally, he was no longer able to be gainfully employed until he made the choice to ignore and work through the delusions/hallucinations he came accustomed to. He basically was a loner who isolated himself out of stigma and the plight of mental illness progression. His best friend would remain in his mind as he would seem awkward and uncomfortable around others. Outside of his workaholic demeanor and apparent extreme delusions, he had very little interpersonal connections with others.

3. My reactions to his various tx. Isolation, insulin shock, meds, denial/refusal to acknowledge hallucinations?

Personally, the learner was not familiar with the insulin shock technique nor would she recommend it as it seemed rather extreme and brutal on a physiological level. Wanda would be more inclined to suggest pharmacological interventions, group therapy, individual, and family psychotherapy because of the progression of the illness. Though concerns of overmedicating may surface, schizophrenia of this magnitude likely will benefit the patient a great deal by at least smoldering some of his more troubling symptoms. There was no choice but to probate him because of his outlandish beliefs; however, basically he was mainly controllable without restraints or any other type of punishing remedy. Denial and refusal to acknowledge hallucinations are reasons for the much needed psychotherapy because otherwise he would likely be admitted to a long term care facility indefinitely or possibly end up on the wrong side of a prison cell.

4. How can the tx be benefitted by family therapy/family systems perspective?

It is nearly essential that John and his family commit to family/couples therapy which would provide insight, reality orientation, supportive guidance, psychoeducation, direction, structure and an outlet to work through this troubling circumstance. It also would provide an avenue for future planning since it is a progressive mental illness. Family therapy could be the foundation that would keep this family together by offering them the assistance they desperately need. Advocacy, caregiver support for the wife, as well as rebuilding a new life around the illness are some of the pertinent aspects required in this case. Helping to put the puzzle pieces together along with collaborating with social and community supports will also help tremendously in the transition of this complex disease.

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